Department of Clinical Laboratory, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 430022, Wuhan, China.
Sci Rep. 2024 May 19;14(1):11424. doi: 10.1038/s41598-024-61771-3.
Tobacco exposure is known to be associated with a higher prevalence and incidence of liver diseases. Cotinine, a metabolite of nicotine, is a typical indicator of tobacco exposure. However, the relationship of serum cotinine levels with hepatic steatosis and liver fibrosis remains controversial and these relationships need more research to explored in American teenagers. Cross-sectional data included 1433 participants aged 12-19 from the National Health and Nutrition Examination Survey (NHANES) from 2017 to 2020 were thoroughly used for this study. The linear relationships between serum cotinine levels and the Liver Stiffness Measurement (LSM) and Controlled Attenuation Parameter (CAP) were examined using multiple linear regression models. Subgroup analysis, interaction tests, and nonlinear interactions were also carried out. Serum cotinine levels > 2.99 ng/ml [β = 0.41 (0.07, 0.76), p = 0.018] and 0.05-2.99 ng/ml [β = 0.24 (0.00, 0.49), p = 0.048] showed a significant positive connection with LSM in multivariate linear regression analysis when compared to serum cotinine levels ≤ 0.05 ng/ml (p for trend = 0.006). Moreover, we discovered an inverted U-shaped association of log2-transformed cotinine with LSM with an inflection point of 4.53 using a two-stage linear regression model. However, according to multiple regression analysis, serum cotinine and CAP did not significantly correlate (p = 0.512). In conclusion, this study demonstrated that smoking cessation and keep away from secondhand smoking may beneficial for liver health in American teenagers.
已知烟草暴露与肝脏疾病的患病率和发病率较高有关。可铁宁是尼古丁的代谢产物，是烟草暴露的典型指标。然而，血清可铁宁水平与肝脂肪变性和肝纤维化之间的关系仍存在争议，这些关系需要更多的研究来探讨美国青少年。本研究充分利用了 2017 年至 2020 年国家健康和营养调查（NHANES）中 1433 名年龄在 12-19 岁的参与者的横断面数据。使用多元线性回归模型研究了血清可铁宁水平与肝硬度测量（LSM）和受控衰减参数（CAP）之间的线性关系。还进行了亚组分析、交互检验和非线性交互检验。与血清可铁宁水平≤0.05ng/ml 相比，血清可铁宁水平>2.99ng/ml[β=0.41（0.07，0.76），p=0.018]和 0.05-2.99ng/ml[β=0.24（0.00，0.49），p=0.048]与 LSM 呈显著正相关（p 趋势=0.006）。此外，我们发现使用两阶段线性回归模型，log2 转换后的可铁宁与 LSM 之间呈倒 U 形关联，拐点为 4.53。然而，根据多元回归分析，血清可铁宁与 CAP 无显著相关性（p=0.512）。总之，本研究表明，美国青少年戒烟和远离二手烟可能有益于肝脏健康。
